2021 Volume 36 Issue 3 Pages 235-240
A 58－year－old woman developed multiple pulmonary metastases 18 months after surgery for malignant melanoma of the left upper arm. She was administered nivolumab/ipilimumab combination therapy. Liver dysfunction, fever, and malaise that occurred after two combination therapies were treated using prednisolone (PSL, 20 mg/day), and the remaining two combination therapies were administered after recovery. The patient showed severe liver dysfunction, and administration of water－soluble PSL ( 1 mg/kg/day) was ineffective. Eventually, the patient responded to mycophenolate mofetil treatment ; however, normalization of liver function occurred after 3 months. Treatment with immune checkpoint inhibitors occasionally results in severe liver dysfunction. Although steroids are considered first－choice treatment, we conclude that prompt administration of mycophenolate mofetil is important in steroid－refractory liver disease. We investigated eight patients who received nivolumab/ipilimumab combination therapy at our hospital and observed various immune－related adverse events associated with immune checkpoint inhibitor administration. These effects showed a tendency to occur at different times depending on the type of inhibitor used. [Skin Cancer (Japan) 2021 ; 36 : 235－240]
